From the Guidelines
I strongly recommend taking a prenatal vitamin that contains at least 400-600 mcg of folic acid, 27 mg of iron, 1000 mg of calcium, 600 IU of vitamin D, and 150 mcg of iodine daily, as supported by the USPSTF recommendation statement 1. The most recent and highest quality study, published in 2020, emphasizes the importance of prenatal vitamins in preventing neural tube defects and supporting fetal development 1. Key components of prenatal vitamins include:
- Folic acid: 400-600 mcg, to prevent neural tube defects 1
- Iron: 27 mg, to support increased blood volume and prevent anemia 1
- Calcium: 1000 mg, to promote fetal bone development 1
- Vitamin D: 600 IU, to support fetal bone development and overall health 1
- Iodine: 150 mcg, to support thyroid function and brain development 1 It is essential to start taking prenatal vitamins at least one month before conception and continue throughout pregnancy and breastfeeding. Additionally, women with specific dietary restrictions or health conditions, such as obesity or diabetes, may require additional supplements, like DHA (an omega-3 fatty acid) for fetal brain development, and should consult their healthcare provider for personalized recommendations 1.
From the FDA Drug Label
The usual therapeutic dosage in adults and children (regardless of age) is up to 1 mg daily... 0.8 mg for pregnant and lactating women, but never less than 0. 1 mg/day. The recommended dose of folic acid for pregnant women is 0.8 mg daily 2.
- The dose should not be less than 0.1 mg/day.
- The maintenance dose for pregnant women is 0.8 mg daily.
From the Research
Prenatal Vitamin Recommendations
- The daily antepartum supplementation of 0.4-0.8 mg of folic acid and 30-60 mg of elemental iron is currently recommended 3
- Prenatal supplements should probably contain other nutrients such as pyridoxine hydrochloride, cholecalciferol, vitamin E, pantothenic acid, calcium, magnesium, zinc, copper, and possibly selenium 3
- The target dose for supplementation is ≥198 mcg retinol activity equivalents of total vitamin A, 7-91 mcg vitamin D, 169-720 mcg dietary folate equivalents of folic acid, 383-943 mg calcium, 13-22 mg iron, and ≥59 mg ω-3 FAs 4
- A novel micronutrient powder containing microencapsulated pH-sensitive calcium in addition to iron and folic acid may be a promising approach for delivering these nutrients as a single daily dose to pregnant women 5
Essential Nutrients for Prenatal Supplements
- Calcium, iron, magnesium, selenium, zinc, and possibly chromium and iodine are essential minerals that decrease during pregnancy if un-supplemented 6
- Vitamins A, C, D, K, B1, B3, B5, B6, folate, biotin, and B12 are essential vitamins that decrease during pregnancy if un-supplemented 7
- Optimal mineral and vitamin supplementation can significantly reduce a wide range of pregnancy complications and infant health problems 6, 7
Commercial Prenatal Supplements
- Commercial prenatal supplements vary widely in mineral and vitamin content, often containing only a subset of essential nutrients, and the levels are often below recommended levels 4, 6, 7
- There is a need to establish recommendations on the optimal level of mineral and vitamin supplementation during pregnancy 6, 7